A 38-year-old man with Marfan syndrome presented with headache and neck pain. MR imaging revealed a large enhancing mass in the cervical anterior epidural space. Cervical laminectomy with biopsy of the lesion revealed a large engorged anterior epidural venous plexus (AEVP). Marfan syndrome may predispose the patient to enlargement of AEVP secondary to a vessel wall abnormality.